LAUSR

Introduction The efficacy of ultrasound-guided corticosteroid injections in the treatment of ulnar neuropathy at the elbow (UNE) has limited support in the literature. This study was designed to describe the effect of a single ultrasound-guided corticosteroid injection on patients with clinical UNE and what factors might predict a good response. Methods Patients with clinical and/or electrodiagnostic evidence of UNE received a diagnostic neuromuscular ultrasound measuring the cross sectional area (CSA) of the ulnar nerve at three locations about the elbow. They then received a single ultrasound-guided injection of 1 cc of 6 mg betamethasone and 1 cc of 1% lidocaine at the location of maximum nerve swelling. Follow up phone interviews were conducted at 2 and 12 weeks. Results Ten patients were enrolled in the study. The average age was 56.5 years. The completion rates for the 2 week and 12 week phone interviews were 10/10 and 9/10 respectively. Six out of 10 indicated the injection improved their symptoms. Only patients with at least one nerve cross sectional area above 10 mm 2 responded favorably to the injection. Large CSA appeared to be a better predictor of response than NCS or EMG parameters. Conclusion Corticosteroid injections around the ulnar nerve may be efficacious in a subset of patients with UNE. An increased nerve CSA may be positively correlated with a favorable outcome following the injection.